Measures of physical activity in Parkinson's disease (MAPD)

Keywords: Parkinson's; Remote monitoring; Physical activity
Purpose: Previous research indicates that Physical Activity (PA) can help people with Parkinson's (PwP) to manage their symptoms but that they are less active than people of the same age and in relation to World Health Organisation (WHO) guidelines of 150min moderate PA per week.
Common measures of PA include questionnaires or accelerometers but these are not routinely used in clinical services. Accelerometers are a potential technological solution to monitor free-living physical activity objectively. Little research has been conducted on patient perceived utility and feasibility of using body-worn accelerometers. This quantitative, observational study assessed the concurrent validity, feasibility and perceived utility of a questionnaire and accelerometer to capture PA in people with newly diagnosed Parkinson's.
This quantitative, observational study assessed the concurrent validity, feasibility and perceived utility of a questionnaire and accelerometer to capture PA in people with newly diagnosed Parkinson's.
Methods: Twenty-four participants were recruited by convenience sampling from a service for newly diagnosed PwP at University Hospitals Plymouth NHS Trust, UK. The study was conducted remotely by telephone, email and postal correspondence. Participants used a wrist-worn accelerometer (GENEActiv™) for one week, completed the International Physical Activity Questionnaire (IPAQ-S) about that week's PA levels and completed a Likert-style utility questionnaire on the perceived utility and feasibility of using the PA measures. We chose measures based on literature review and patient input.
Energy expenditure (metabolic equivalents – METS) calculated from the two PA measures were compared using Spearman's correlation. Descriptive statistics summarised PA levels in relation to WHO guidelines and the feasibility of measures based on responses to the utility questionnaire.
Results: The sample (N=24, 17 males, 7 females; mean age 72.4 years, SD±9.7; mean disease duration 1 years) showed a moderate correlation between total weekly energy expenditure recorded by the PA measures (rs=0.55, n=24, p=.003).
Overall, the sample was above guidelines for moderate PA (IPAQ-S mean 342min per week, range 0–1740, SD±479; GENEActiv™ mean 265min per week, range 1–794, SD±217).
Participants disagreed with the statement ‘I would rather fill in a PA questionnaire about the previous week than wear the sensor for a week’ (median response 4=disagree, IQR 2) but agreed ‘the PA questionnaire was easy to fill in’ (median response 2=agree, IQR 2).
Conclusion(s): Findings suggest it is feasible to introduce a measure of PA to patients and to do this remotely. There was wide variation between the measures when determining levels of moderate PA. Validation of the GENEActiv™ device against gold standard meaures of energy expenditure and PA intensity in a Parkinson's population is required to establish criterion validity.
Impact: This work contributes to the understanding of using measures of PA in a Parkinson's population. It also contributes to the understanding of patient experience and preferences in remote monitoring of PA in order to plan service provision to support PA in PwP.
Funding acknowledgements: This project was supported by a Health Education England funded Masters in Clinical Research. Further postgraduate work is supported by National Institute of Health Research Pre-doctoral Clinical Academic Fellowship funding.